Provider Demographics
NPI:1871879486
Name:SOS HEALTH MEDICAL TRANSPORTATION
Entity type:Organization
Organization Name:SOS HEALTH MEDICAL TRANSPORTATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:ATTOH
Authorized Official - Middle Name:
Authorized Official - Last Name:MOUTCHIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:302-777-1010
Mailing Address - Street 1:700 CORNELL DR
Mailing Address - Street 2:STE. E12
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19801-5762
Mailing Address - Country:US
Mailing Address - Phone:302-777-1010
Mailing Address - Fax:302-777-1011
Practice Address - Street 1:700 CORNELL DR
Practice Address - Street 2:STE. E12
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19801-5762
Practice Address - Country:US
Practice Address - Phone:302-777-1010
Practice Address - Fax:302-777-1011
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-26
Last Update Date:2012-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE2011120605343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE205152Medicaid